Organization
VIVID SMILES
Active
Other names
Vivid Smiles
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JORGE VIVONI DMD (DENTIST)
(703) 333-6077
Entity
Organization
Contact information
Practice address
7011 BACKLICK CT, SPRINGFIELD, VA 22151-3903
(703) 333-6077
Mailing address
7011 BACKLICK CT, SPRINGFIELD, VA 22151-3903
(703) 333-6077
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
07/30/2021
Last updated
07/30/2021
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